ABSTRACT
Background: The prevalence of adrenal insufficiency and association of serum cortisol with prognosis in intensive care unit patients is controversial. Some studies have shown a direct association between serum cortisol and bad prognosis while in other studies no such association has been made
Objective: This study was designed to evaluate the association between serum cortisol and prognosis of patients in intensive care unit
Methods: This was a cross-sectional study performed on intensive care unit patients of Bou-Ali teaching hospital in Qazvin [Iran] in 2009. Serum cortisol levels were measured before and after injection of cosyntropin. Basal cortisol level below 441 nmol/l was interpreted as adrenal insufficiency. In patients with serum cortisol between 441 and 938 nmol/l following injection of cosyntropin the level of serum cortisol was re-measured after 60 min. Patients with serum cortisol response less than 255 nmol/l were interpreted as having partial adrenal insufficiency. Later, patients were divided into 4 groups based on APACHE scoring system. Association of serum cortisol with APACHE score, hypotension, intubation, and mortality was evaluated
Findings: Of 60 patients under study, none found to have adrenal insufficiency. Serum cortisol was independently associated with mortality, hypotension, and intubation
Conclusion: Based on results found through this study, Adrenal insufficiency was not common in ICU patients and serum cortisol could be used as a predictor of prognosis
ABSTRACT
High serum uric acid is associated with kidney damage manifested by glomerular sclerosis, hypertrophy and albuminuria in animal models. To evaluate the relationship between elevated serum uric acid and urinary albumin/creatinine ratio in type2 diabetes. In this cross-sectional study, 290 patients [130 males and 160 females] with type 2 diabetes were recruited for measuring, cholesterol, triglycerides, uric acid and albumin/creatinine ratio [ACR]. The data obtained for albumin/creatinine ratio were expressed as mean +/- SD or percentage and a P value 0.05 was considered as significant. One-way analysis of variance and Pearson correlation coefficient were used for statistical studies. The mean ages of patients were 58.2 +/- 8.6 years. Uric acid levels for normalbuminuria, microalbuminuria and marcoalbuminuria were [5.1 +/- 0.7, 6.3 +/- 1.1, and 8.1 +/- 1.3 mg/dl, respectively]. While the uric acid level in men was shown to have a positive correlation with natural logarithmic ACR [Ln [ACR]], [Segma=0.53, p<0.05], a positive correlation with both triglycerides and Ln [ACR] was found among women [Segma=0.263, P<0.01]. Based on our data, serum uric acid was found to be independently correlated with urinary ACR in patients with type 2 diabetes